Should We Place Ureteral Stents in Retroperitoneal Laparoscopic Ureterolithotomy?: Consideration of Surgical Techniques and Complications
유재형, 김영곤, 김명기,
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유재형 ( You Jae-Hyung )
Chonbuk National University Medical School Department of Urology
김영곤 ( Kim Young-Gon )
Chonbuk National University Medical School Department of Urology
김명기 ( Kim Myung-Ki )
Chonbuk National University Medical School Department of Urology
KMID : 0358320140550080511
Abstract
Purpose: There is some debate over the necessity of ureteral stenting after laparoscopic ureterolithotomy. We evaluated the need for ureteral stenting after retroperitoneal laparoscopic ureterolithotomy (RLU).
Materials and Methods: Between January 2009 and January 2013, 41 patients underwent RLU to remove upper ureteral stones. The retroperitoneal approach was used in all patients by a single surgeon. A double J (D-J) stent was placed in the first 17 patients after the procedure but not in any of the next 24 patients.
Results: The mean patient age, serum creatinine levels, and stone size were not significantly different between the two groups. The stone-free rate was 100%. The mean operative time was significantly shorter in the stentless group than in the stent group (59.48 minutes vs. 77.88 minutes, p<0.001). Parenteral analgesic use and anticholinergic medication use were observed in the stent group only. The blood loss, drain removal day, and hospital stay were not significantly different between the two groups. No other significant complications occurred during or after the operation in any patients.
Conclusions: LU is a safe and effective treatment modality for large impacted ureteral stones. In this study, D-J stent placement was not necessary after RLU. In the future, large-scale studies of RLU without D-J stenting, especially on the frequency of the development of complications according to the surgical technique, may be needed.
키워드
Laparoscopy;Ureteral calculi;Ureteral catheter
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